ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Contrary to Popular Belief, Consumption of Mineral Waters Does Possess an Erosive Potential, Although Less Than That of Soft Drink Beverages
Clinical Question In high caries risk patients, does consuming mineral water have the same erosive potential on enamel as soft drink beverages?
Clinical Bottom Line For patients that drink mineral waters, studies have shown that these drinks do erode dental enamel, although at a lower rate compared to soft drink beverages. This is supported by studies that have compared the erosive effects of mineral waters to colas, finding visible areas of pitted enamel, signifying demineralization.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 12165767Dincer/200260 human premolars extracted for orthodontic treatment (40 in the experimental group, 20 in the control group)Laboratory study
Key resultsIn the premolars exposed to sparkling mineral water, less demineralization was observed as indicated by a visible dissolved area compared to teeth exposed to cola, orange soda, and lemon soda.
#2) 11556958Parry/2001160 extracted human permanent teeth from patients 30 years old or younger (8 for each test solution); synthetic hydroxyapatite powdersLaboratory study
Key resultsParry found that the highest dissolution level on dental enamel of various mineral water and sparkling water brands was 0.017 micrograms and 0.082 micrograms, respectively. In comparison, the values for sodas ranged from 2.754 to 7.113 micrograms. Similar findings were found when the liquids were tested on synthetic hydroxyapatite powders.
Evidence Search ((("dental enamel"[MeSH Terms] OR ("dental"[All Fields] AND "enamel"[All Fields]) OR "dental enamel"[All Fields] OR "enamel"[All Fields]) AND ("carbonated beverages"[MeSH Terms] OR ("carbonated"[All Fields] AND "beverages"[All Fields]) OR "carbonated beverages"[All Fields] OR ("soft"[All Fields] AND "drinks"[All Fields]) OR "soft drinks"[All Fields])) OR "tooth erosion"[MeSH Terms]) AND "mineral waters"[MeSH Terms]
Comments on
The Evidence
Validity: Both studies were in vitro studies using extracted human teeth, exposing them to various beverages while measuring the effect on dental enamel. Both studies included an adequate sample size but only the Dincer study simulated an oral environment, taking into account possible conditions in the human mouth. Perspective: Since these studies were conducted in vitro and one did not take extra measures to simulate an oral environment, other factors that exist in a real world situation in the human oral cavity may have not been accounted for that could potentially affect the findings. However, as is, the findings are telling that there is a noticeable erosive effect on dental enamel when exposed to mineral waters. More in vivo studies need to be conducted as well as studies done in actual patients to support the study conclusions, since these were all laboratory findings.
Applicability The evidence found that mineral water does lead to demineralization of enamel, but less so when compared to soft drinks. This information is relevant to the practice of dentistry to help educate patients about their diet choices and the potential effects it may have on their oral health. In this case, this information is pertinent in debunking the stigma that mineral water is entirely healthy and not harmful for the oral cavity.
Specialty/Discipline (Public Health) (General Dentistry)
Keywords Nutrition, mineral water, enamel erosion, demineralization, diet, dental erosion, soft drinks
ID# 3146
Date of submission: 03/16/2017spacer
E-mail nguyenaq@livemail.uthscsa.edu
Author Anthony Q. Nguyen
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Georgiana S. Gross MPH, RD, LD
Faculty mentor/Co-author e-mail grossg@uthscsa.edu
Basic Science Rationale
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